Jochum: Iowa Legislature reaches agreement on health care

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Pam Jochum

Terry Branstad

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Posted: Wednesday, May 22, 2013 1:59 pm

Iowa will accept federal funding to expand health care to low-income residents under a compromise reached between statehouse Democrats and Republican Gov. Terry Branstad, Senate President Pam Jochum says.

Jochum, D-Dubuque, said an agreement was reached late Tuesday evening on an issue that has dominated the 2013 legislative session. Jochum said the compromise will be included in the Department of Human Services bill, which will be voted on Wednesday afternoon.

The legislation will be called the Iowa Health and Wellness Plan. Jochum said the state will accept federal funding from Medicaid expansion to cover approximately 150,000 new enrollees.

“It was a big breakthrough,” Jochum told the TH today. “A lot of people thought we’d never reach agreement, and we did.”

Residents up to 100 percent of the federal poverty line — $11,490 for an individual or $19,530 for a family of three, for example — will receive the same benefits as state employees, and those premiums will be paid for entirely by federal Medicaid dollars.

Residents between 101 percent and 138 percent of the poverty line will receive insurance from exchanges created by the new federal health care law. Those residents’ premiums will be paid for with Medicaid funds in the first year, and also in ensuing years provided they accomplish physicians’ directives such as wellness check-ups and diet counseling. If a person does not accomplish those objectives, he or she must pay a portion of the premium up to 2 percent of household income.

Branstad had been resistant to accepting expanded Medicaid funding, citing concerns with the federal government’s ability to deliver on the funds. Branstad instead developed his own plan, an expansion of IowaCare, the state’s current plan for low-income residents. That plan covered only residents up to 100 percent of the poverty line.

Democrats meanwhile have pushed for Medicaid expansion, which was optional to states under the federal Affordable Care Act, to serve residents up to 138 percent of the poverty line.

Jochum said she had been working on the compromise since Friday with Democratic Sen. Amanda Ragan and Republican House Majority Leader Linda Upmeyer. Jochum said the governor's office got involved Tuesday, and an agreement was reached late Tuesday evening.

A spokesperson for Branstad said the governor supports the compromise and commends legislators in both parties and both chambers for their work on the bill.

"The governor was clear from the onset that two things needed to happen with regard to health care reform. First, taxpayers needed to be protected in the event the federal government did not come through on its funding promises. Second, the governor wanted to ensure we were focused on health outcomes and making Iowans healthier," Branstad spokesperson Tim Albrecht said. "This requirement was met in both cases under the Iowa Health and Wellness Plan. ... This is a modernization of Medicaid and will serve both patients and taxpayers at a superior level."

Per the federal health care law, the federal government will pay for the lion's share of Medicaid expansion: 100 percent in the first three years, reducing gradually over 10 years to 90 percent.

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